Transgender sexuality#Trans men attracted to men

Historically, clinicians labelled trans people as heterosexual or homosexual relative to their sex assigned at birth.Chivers, Meredith L.; Bailey, J. Michael. Sexual Orientation of Female-to-Male Transsexuals: A Comparison of Homosexual and Nonhomosexual Types. Archives of Sexual Behavior Within the transgender community, sexual orientation terms based on gender identity are the most common, and these terms include lesbian, gay, bisexual, asexual, queer, and others.{{Cite web|date=2013-06-05|title=Wonky Wednesday: Trans people & sexual orientation|url=https://www.thetaskforce.org/wonky-wednesday-trans-people-sexual-orientation/|access-date=2021-02-03|website=National LGBTQ Task Force}}

In the United States, transgender respondents to one 2015 survey self-identified as queer (21%), pansexual (18%), gay, lesbian, or same-gender-loving (16%), straight (15%), bisexual (14%), and asexual (10%).{{Cite web |url=http://www.transequality.org/sites/default/files/docs/usts/USTS%20Full%20Report%20-%20FINAL%201.6.17.pdf|title=The Report of the 2015 U.S. Transgender Survey|last=James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M.|date=2016|publisher=National Center for Transgender Equality}} A second study found 23% reported being gay, lesbian, or same-gender-loving, 25% bisexual, 4% asexual, 23% queer, 23% straight and 2% something else.{{Cite web |url=http://www.thetaskforce.org/wonky-wednesday-trans-people-sexual-orientation/|title=WONKY WEDNESDAY: TRANS PEOPLE & SEXUAL ORIENTATION|last=Harrison, Jack|date=5 June 2013|publisher=Task Force and the National Center for Transgender Equality}}

A 2015 survey of roughly 3,000 American trans women showed that at least 60% were attracted to women and 55% were attracted to men.{{cite web|title=Injustice at Every Turn: A Report of the National Transgender Discrimination Survey|publisher=National Center for Transgender Equality & National Gay and Lesbian Task Force|page = 29|url=http://transequality.org/PDFs/NTDS_Report.pdf|date=2015-01-21|archive-url=https://web.archive.org/web/20160305015525/http://www.transequality.org/issues/resources/national-transgender-discrimination-survey-full-report|archive-date=2016-03-05}} Of the trans women respondents 27% answered gay, lesbian, or same-gender-loving, 20% answered bisexual, 19% heterosexual, 16% pansexual, 6% answered asexual, 6% queer, and 6% did not answer.

Foerster reported a 15-year successful relationship between a woman and a trans man who transitioned in the late 1960s.{{cite journal|last1=Foerster|first1=DW|year=1983|title=Female to Male Transsexual Conversion: A 15-Year Follow-Up|journal=Plastic and Reconstructive Surgery|volume=72|issue=2|pages=237–40|doi=10.1097/00006534-198308000-00024|pmid=6683850}}G. Kockott, E. -M. Fahrner (1988). Male-to-female and Female-to-male transsexuals: A comparison. Archives of Sexual Behavior, Volume 17, Number 6 / December, 1988

In the 20th century, trans men attracted to women struggled to demonstrate the existence and legitimacy of their identity.Henry Rubin (2003). Self-made Men: Identity and Embodiment Among Transsexual Men. Vanderbilt University Press, {{ISBN|978-0-8265-1435-6}} Many trans men attracted to women, such as jazz musician Billy Tipton, kept their trans status private until their deaths.

Until the mid-2010s, medical textbooks commonly suggested that most transgender men were straight.{{cite book|author=Michael Shankle|url=https://books.google.com/books?id=xq5LU0iK1Y4C&pg=RA1-PT175|title=The Handbook of Lesbian, Gay, Bisexual, and Transgender Public Health: A Practitioner's Guide to Service|publisher=Routledge|year=2013|isbn=978-1-136-57355-2|page=175|access-date=January 10, 2016}}{{cite book|url=https://books.google.com/books?id=AvfkAgAAQBAJ&pg=PA252|title=Principles and Practice of Sex Therapy, Fifth Edition|publisher=Guilford Publications|year=2014|isbn=978-1-4625-1389-5|page=252|access-date=January 10, 2016|author=Yitzchak M. Binik |author2=Kathryn S. K. Hall }} However, a 2015 survey of roughly 2000 American trans men showed more variation in sexual orientation or sexual identity among trans men. 23% identified as heterosexual or straight. The vast majority (65%) identified their sexual orientation or sexual identity as queer (24%), pansexual (17%), bisexual (12%), gay/same-gender loving (12%), asexual (7%), and 5% did not answer.{{cite web |last1=James |first1=S.E. |last2=Herman |first2=J.L. |last3=Rankin |first3=S. |last4=Keisling |first4=M. |last5=Mottet |first5=L. |last6=Anafi |first6=M. |title=The Report of the 2015 U.S. Transgender Survey |url=https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf |access-date=1 June 2018 |website=2015 US Transgender Survey |publisher=National Center for Transgender Equality |ref=NCTE USTS}} Author Henry Rubin wrote that "[i]t took the substantial efforts of Lou Sullivan, a gay FTM activist who insisted that female-to-male transgender people could be attracted to men." Matt Kailey, author of Just Add Hormones: An Insider's Guide to the Transsexual Experience,Kailey, Matt (2006). Just Add Hormones: An Insider's Guide to the Transsexual Experience, Beacon Press, {{ISBN|978-0-8070-7959-1}} recounts his transition "from 40-something straight woman to the gay man he'd always known himself to be."Jacob Anderson-Minshall (January 19, 2006) Invisible Man. San Francisco Bay Times Researchers eventually acknowledged the existence of this phenomenon, and by the end of the 20th century, psychiatrist Ira Pauly wrote, "The statement that all female-to-male transgender are homosexual [Pauly means attracted to women] in their sexual preference can no longer be made."Ira B. Pauly (1998). Gender Identity and Sexual Orientation. In Dallas Denny, ed. Current Concepts in Transgender Identity. Routledge, {{ISBN|978-0-8153-1793-7}}

Trans gay men have varying levels of acceptance within other communities.Szymanski, Zak (January 19, 2006). [http://www.ebar.com/news/article.php?sec=news&article=523 Leather community debates trans exclusion at upcoming contest.] Bay Area Reporter

{{See also|Third gender}}

Psychiatrist Richard Green, in an appendix to Harry Benjamin's 1966 The Transsexual Phenomenon, considers people who were assigned male at birth who have adopted a more feminine gender role. In this broad overview, entitled "Transsexualism: Mythological, Historical, and Cross-Cultural Aspects", Green argues that the members of these groups are mentally indistinguishable from modern western transsexual women.Green R (1966) [http://www2.hu-berlin.de/sexology/ECE6/html/benjamin/appendix_c.htm Transsexualism: Mythological, Historical, and Cross-Cultural Aspects.] {{webarchive|url=https://web.archive.org/web/20121023220011/http://www2.hu-berlin.de/sexology/ECE6/html/benjamin/appendix_c.htm |date=2012-10-23 }} in Benjamin H, The Transsexual Phenomenon. Julian Press {{ASIN| B0007HXA76}} They have in common early effeminacy, adulthood femininity, and attraction to masculine males.{{cite book |last=Barrett |first=Jackson |url=https://books.google.com/books?id=I-8qZlGIpnQC&q=Secondary+primary+transsexual |title=Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management |publisher=Radcliffe Publishing |year=2007 |isbn=978-1-85775-719-4 |edition=illustrated |series=Radcliffe Series |pages=1–298 |language=en |author-link=James Barrett (academic)}}

The Hijra of the Indian Subcontinent are people who were assigned male at birth but occupy a female sexual and/or gender role, sometimes undergoing castration.See, for example, [http://www.rhcatalyst.org/site/PageServer?pagename=Programs_STI_Prevention_Bangladesh In Their Own Words: The Formulation of Sexual and Reproductive Health Behaviour Among Young Men in Bangladesh] {{Webarchive|url=https://web.archive.org/web/20120222232611/http://www.rhcatalyst.org/site/PageServer?pagename=Programs_STI_Prevention_Bangladesh |date=2012-02-22 }}, Shivananda Khan, Sharful Islam Khan and Paula E. Hollerbach, for the Catalyst Consortium. As adults, they occupy a female role, but traditionally Hijra describe themselves as neither male nor female, preferring Hijra as their gender. They often express their femininity in youth; as adults, they are usually sexually-oriented towards masculine men.

Mukhannathun were transgender individuals of the Muslim faith and Arab extraction who were present in Medina and Mecca during and after the time of Muhammad.{{cite journal

| last = Rowson

| first = Everett K.

| title = The Effeminates of Early Medina

| journal = Journal of the American Oriental Society

| volume = 111

| issue = 4

| pages = 671–693

| date = October 1991

| url = http://www.williamapercy.com/wiki/images/The_effeminates_of_early_medina.pdf

| doi = 10.2307/603399

| jstor = 603399

| citeseerx = 10.1.1.693.1504

| access-date = 2009-05-01

| archive-date = 2008-10-01

| archive-url = https://web.archive.org/web/20081001195534/http://www.williamapercy.com/wiki/images/The_effeminates_of_early_medina.pdf

| url-status = dead

}} Ibn Abd Al-Barh Al-Tabaeen, a companion of Aisha Umm ul-Mu'min'in who knew the same mukhannath as Mohammed, stated that "If he is like this, he would have no desire for women and he would not notice anything about them. This is one of those who have no interest in women who were permitted to enter upon women."{{cite book

|last=Al Muqni

|first=Matan

|title=al Sharh al Kabeer

|volume=7

|pages=347–348

|language=ar}} That said, one of the Mukhannath of Medina during Muhammad's time had married a woman.

Beyond western cultures, sexual behavior and gender roles vary, which affects the place of gender variant people in that culture.{{Cite book|last=Bosson, Jennifer K.|title=The psychology of sex and gender|others=Vendello, Joseph A.,, Buckner, Camille E.|date=27 February 2018|isbn=978-1-5063-3132-4|location=Thousand Oaks, California|pages=89–90|oclc=1004248895}} Nadleehe of the North American Navajo hold a respected ceremonial position, whereas the Kathoey of Thailand experience more stigma comparatively.

In Iran, while sex change is somewhat accepted, the society is heteronormative. As homosexuality is punishable by death, it is more common to see a trans man being in a relationship with a woman and a trans woman in a relationship with a man.{{Cite journal |last=Saeidzadeh |first=Zara |date=2020-04-02 |title='Are trans men the manliest of men?' Gender practices, trans masculinity and mardānegī in contemporary Iran |journal=Journal of Gender Studies |volume=29 |issue=3 |pages=295–309 |doi=10.1080/09589236.2019.1635439 |s2cid=199145725 |issn=0958-9236|doi-access=free }}

{{See also|Human sexual activity}}

Mira Bellwether's self-published 2010 'zine Fucking Trans Women{{cite book |last1=Bellwether |first1=Mira |author-mask=Bellwether, Mira (author and illustrator)|title=Fucking Trans Women #0 |type='zine |date=October 2010 |publisher=Self-published |isbn= |url=https://archive.org/details/FuckingTransWomen0 |access-date=14 December 2022 |via=Internet Archive}} was a landmark work in its focus on the perspectives and experiences of trans women,{{cite journal |last1=Pfeffer |first1=Carla A. |title=Making Space for Trans Sexualities |journal=Journal of Homosexuality |date=4 May 2014 |volume=61 |issue=5 |pages=597–604 |doi=10.1080/00918369.2014.903108 |publisher=Routledge|pmid=24717171 |s2cid=32349953 }} and has been described in Sexuality & Culture as "a comprehensive guide to trans women's sexuality".{{cite journal |last1=Rosenberg |first1=Shoshana |last2=Tilley |first2=P. J. Matt |last3=Morgan |first3=Julia |title='I Couldn't Imagine My Life Without It': Australian Trans Women's Experiences of Sexuality, Intimacy, and Gender-Affirming Hormone Therapy |journal=Sexuality & Culture |date=September 2019 |volume=23 |issue=3 |pages=962–977 |doi=10.1007/s12119-019-09601-x|s2cid=255519091 }} It focuses in particular on sex acts possible with flaccid penises and on the innervation of pre-op and non-op trans women's genital areas.{{cite news |last1=Valens |first1=Ana |title=Here's what you need to know before having sex with a trans woman |url=https://www.dailydot.com/irl/trans-sex-myths-sex/ |department=Trans/Sex |website=The Daily Dot |access-date=14 December 2022 |date=22 March 2019}} It both named and popularized the act of muffing, or stimulating the inguinal canals through an invaginated scrotum,{{cite book |last1=Fielding |first1=Lucie |title=Trans Sex: Clinical Approaches to Trans Sexualities and Erotic Embodiments |date=2021 |publisher=Routledge |location=New York City, N.Y., U.S. |isbn=978-0-429-31829-0}} which can offer those with genital dysphoria a way to be penetrated from the front.{{cite news |last1=Hill-Meyer |first1=Tobi |title=Muffing 101 |url=https://www.autostraddle.com/muffing-101/ |access-date=14 December 2022 |department=Lesbian Sex |work=Autostraddle |date=7 February 2022}}

Cultural studies scholar J.R. Latham wrote the first definitive analysis of trans men's sexual practices in the journal Sexualities.{{cite journal|last1=Latham|first1=JR|s2cid=147597591|title=Trans men's sexual narrative-practices: Introducing STS to trans and sexuality studies|journal=Sexualities|date=March 2016|volume=19|issue=3|pages=347–368|doi=10.1177/1363460715583609}}

Few documentaries have been produced exploring transgender people's sexual practices.

Since 2013, creator Tobi Hill-Meyer has been working on a series of projects related to transgender peoples sexualities titled Doing it Again.{{cite web|url=https://tobihillmeyer.com/film-screenings/|title= Toby Hill-Meyer Filmography|website=handbasketproductions.com|date= 3 May 2019}}

Research in areas of sexual behavior and experience is ongoing. One study from 2020 conducted in Spain analyzed the sexual health and behaviors of 260 participants.{{cite journal|last1=Gil-Llario|first1=MD|last2=Gil-Juliá|first2=B|last3=Giménez-García|first3=C|last4=Bergero-Miguel|first4=T|last5=Ballester-Arnal|first5=R|title=Sexual behavior and sexual health of transgender women and men before treatment: Similarities and differences|journal=International Journal of Transgender Health|date=November 8, 2020|volume=22|issue=3|pages=304–315|doi=10.1080/26895269.2020.1838386|pmid=34240073 |pmc=8118227 }}

{{further|Terminology of transgender anatomy}}

Many transgender individuals choose to not use the language that is typically used to refer to sexual body parts, instead using less gendered words. The reason for this practice, is that hearing the typical names for genitalia and other sexual body parts can cause severe gender dysphoria for some trans people.{{Cite book|title=Trans bodies, trans selves a resource for the transgender community|editor=Erickson-Schroth, Laura|isbn=978-0-19-932535-1|oclc=944726648|year=2014|publisher=Oxford University Press |url-access=registration|url=https://archive.org/details/transbodiestrans0000unse}}

Not all transgender people choose to rename their bodies. Those that choose not to rename their body, are often less uncomfortable with their body and/or do not associate their sexual body parts with a gender that differs from the one that they identify with. Ultimately, the decision of what language a trans person chooses to use for their body, and wants others to use, is up to the individual whose body is being named.{{rp|pp=355–356}}

Some trans women choose to refer to their anuses as a vagina, pussy, or cunt. (Cunt may also refer to either inguinal canal.) Terms used for the penis include junk, strapoff, strapless, clit, and hen.{{rp|pp=355–356}}{{rp|loc=p. 96, Table 3.1}}

Some trans men refer to their vaginas as their front holes because they find that term less gendered; some use terms like man cave, bonus hole, or boy cunt. Terms used for the clitoris include the dick, cock, dicklet, while the breasts may be called the chesticles.{{rp|pp=355,362}}{{rp|loc=p. 96, Table 3.1}}

For transgender women, taking estrogen stimulates the development of breast tissue, causing them to increase in both size and sensitivity. This increased sensitivity can be pleasurable, painful, or both, depending on the person and the type of stimulation. Furthermore, for those taking estrogen and who have male genitalia, estrogen can (and often does) shrink the external male genitalia and decrease the production of semen (at times bringing the sperm count to zero), and can decrease the ability for the male genitalia to become erect. In addition to these changes, some transgender women going through hormone therapy (HRT) can experience changes in the way their orgasms feel. For example, some people report the ability to experience multiple orgasms.

HRT can cause decrease in sex drive or a change in the way arousal is experienced by trans women. A study published in 2014 found that 62.4% of trans women surveyed reported a decrease in sexual desire after hormone therapy and/or vaginoplasty.{{Cite journal | doi=10.1111/jsm.12365| title=Sexual Desire in Trans Persons: Associations with Sex Reassignment Treatment| year=2014| last1=Wierckx| first1=Katrien| last2=Elaut| first2=Els| last3=Van Hoorde| first3=Birgit| last4=Heylens| first4=Gunter| last5=De Cuypere| first5=Griet| last6=Monstrey| first6=Stan| last7=Weyers| first7=Steven| last8=Hoebeke| first8=Piet| last9=t'Sjoen| first9=Guy| journal=The Journal of Sexual Medicine| volume=11| issue=1| pages=107–118| pmid=24165564}} A 2008 study reported hypoactive sexual desire disorder (HSDD) in as many as one in three post-operative trans women on HRT, while around a quarter of the cisgender female controls were judged to have the disorder. There was no difference between the two group's reported sexual desire.{{Cite journal |doi = 10.1530/eje-07-0511|title = Hypoactive sexual desire in transsexual women: Prevalence and association with testosterone levels|year = 2008|last1 = Elaut|first1 = Els|last2 = De Cuypere|first2 = Griet|last3 = De Sutter|first3 = Petra|last4 = Gijs|first4 = Luk|last5 = Van Trotsenburg|first5 = Michael|last6 = Heylens|first6 = Gunter|last7 = Kaufman|first7 = Jean-Marc|last8 = Rubens|first8 = Robert|last9 = t'Sjoen|first9 = Guy|journal = European Journal of Endocrinology|volume = 158|issue = 3|pages = 393–399|pmid = 18299474|doi-access = free}}

Some trans women and healthcare providers anecdotally report the use of progestogens increasing libido.{{Cite web|title=Overview of feminizing hormone therapy {{!}} Gender Affirming Health Program|url=https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy|access-date=2021-10-03|website=transcare.ucsf.edu}}

A 2009 pilot study tested the effectiveness of two treatments for HSDD in trans women: transdermal testosterone and oral dydrogesterone (a progestin).{{cite journal | vauthors = Kronawitter D, Gooren LJ, Zollver H, Oppelt PG, Beckmann MW, Dittrich R, Mueller A | title = Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study | journal = European Journal of Endocrinology | volume = 161 | issue = 2 | pages = 363–8 | date = August 2009 | pmid = 19497984 | doi = 10.1530/EJE-09-0265| doi-access = }} After six weeks of treatment, the group treated with testosterone reported improved sexual desire, while the group treated with the progestin reported no change.

For transgender men, one of the most notable physical changes that many taking testosterone experience, in terms of sexuality and the sexual body, is the stimulation of clitoral tissue and the enlargement of the clitoris.{{Cite journal|last1=Davis|first1=Samuel A.|last2=Colton Meier|first2=S.|s2cid=144469446|date=2014-04-03|title=Effects of Testosterone Treatment and Chest Reconstruction Surgery on Mental Health and Sexuality in Female-To-Male Transgender People|journal=International Journal of Sexual Health|volume=26|issue=2|pages=113–128|doi=10.1080/19317611.2013.833152|issn=1931-7611}} This increase in size can range anywhere from just a slight increase to quadrupling in size.{{Cite book|title=Transgender history: the roots of today's revolution|last=Stryker, Susan |isbn=978-1-58005-689-2|edition= Second|location=New York, NY|oclc=990183211|date=2017-11-07 }} Other effects can include vaginal atrophy, where the tissues of the vagina thin and may produce less lubrication. This can make sex with the female genitalia more painful and can, at times, result in bleeding. Transgender men taking testosterone are likely at increased risk of developing urinary tract infections, especially if they have receptive vaginal intercourse.{{cite web |url=https://www.sfaf.org/collections/beta/qa-gynecologic-and-vaginal-care-for-trans-men/ |title=Q&A: Gynecologic and vaginal care for trans men |last=Land |first=Emily |date=July 23, 2019 |publisher=San Francisco AIDS Foundation |access-date=April 5, 2020}}

Other effects that testosterone can have on transgender men can include an increase in their sex drive/libido. At times, this increase can be very sudden and dramatic. Like transgender women, some transgender men also experience changes in the way they experience arousal.

{{see also|Gender-affirming surgery}}

Trans women who have undergone vaginoplasty must dilate in order to properly shape and form the neovagina. After several months, sexual intercourse can replace dilation, but if not sexually active, dilation is required again, for the rest of the patient's life.{{cite web |url=https://www.vogue.com/article/breathless-karley-sciortino-trans-sex |title=Why One Trans Woman Wants to Discuss Sex After Surgery |date=August 3, 2016 |website=Vogue |access-date=July 9, 2021}}

{{Primary sources|section|date=June 2020}}

Some trans people maintain a consistent orientation throughout their lives,Ashley A, Thompson D (1986). The First Lady. John Blake Publishing, {{ISBN|1-84454-231-9}}Cossey C (1992). My Story. Faber & Faber, {{ISBN|0-571-16251-7}} in some cases remaining with the same partner through transition.Boylan JF (2003). She's Not There: A Life in Two Genders. Broadway {{ISBN|0-7679-1404-X}}

A 2013 study found that 58.2 percent of its 452 transgender and gender-nonconforming respondents experienced sexual attraction changes during their lives, with trans masculine people more likely to experience "sexual fluidity".{{cite journal |last1 = Katz-Wise|first1 = S.L.|last2=Reisner|first2=S.L.|last3=White Hughto|first3=J.|last4=St. Amand|first4=C.|year = 2016|title = Differences in sexual orientation diversity and sexual fluidity in attractions among gender minority adults in Massachusetts.| journal = The Journal of Sex Research | volume = 53 | issue = 1| pages = 74–84 | doi = 10.1080/00224499.2014.1003028| pmid=26156113 | pmc=4685005 }} For transgender people who socially transitioned (about half of the total sample), 64.4 percent experienced attraction changes after transitioning, with trans feminine people more likely to experience sexual fluidity. A 2014 study of 70 trans women and 45 trans men had similar results, with trans women more likely to experience a change in sexual orientation (32.9 percent experienced changes versus 22.2 percent of trans men).{{cite journal |last1 = Auer|first1 = M.K.|last2=Fuss|first2=J.|last3=Höhne|first3=N.|last4=Stalla|first4=G.K.| last5=Sievers|first5=C.|year = 2014|title = Transgender transitioning and change of self-reported sexual orientation.| journal = PLoS One | volume = 9 | issue = 10| pages=e110016 | doi = 10.1371/journal.pone.0110016| pmid=25299675 | pmc=4192544 | bibcode=2014PLoSO...9k0016A | doi-access=free }} In both groups of the 2014 study, trans people initially more attracted to the opposite of the sex they were assigned at birth were significantly more likely to experience sexual orientation changes (i.e. trans men initially attracted to men and trans women initially attracted to women changing their orientations). These sexual orientation changes could occur at any point in the transition process.

Some gynephilic trans women self-report that after transitioning, they became sexually oriented towards males, and explain this as part of their emerging female identity.{{cite journal | last1 = Daskalos | first1 = CD | s2cid = 476834 | year = 1998 | title = Changes in the Sexual Orientation of Six Heterosexual Male-to-Female Transsexuals | journal = Archives of Sexual Behavior | volume = 27 | issue = 6| pages = 605–614 | doi = 10.1023/A:1018725201811 | pmid = 9883308 }} Kurt Freund hypothesized that such reports might reflect the desire of some trans women to portray themselves as "typically feminine" or, alternatively, might reflect their erotic interest in the validation provided by male partners, rather than representing a genuine change in preference.{{Cite journal|last1=Lawrence|first1=Anne A.|last2=Latty|first2=Elizabeth M.|last3=Chivers|first3=Meredith L.|last4=Bailey|first4=J. Michael|date=2005-04-01|title=Measurement of Sexual Arousal in Postoperative Male-to-Female Transsexuals Using Vaginal Photoplethysmography|journal=Archives of Sexual Behavior|language=en|volume=34|issue=2|pages=135–145|doi=10.1007/s10508-005-1792-z|pmid=15803248|s2cid=8356885|issn=1573-2800}} {{subscription required}} A 2005 study which relied upon vaginal photoplethysmographies to measure blood-flow in the genitalia of postoperative trans women found they had arousal patterns which were category specific (i.e. androphilic trans women were aroused by males, gynephilic trans women were aroused by females) in a similar fashion to natal males, and argue that vaginal photoplethysmographies are a useful technology for measuring the validity of such reports. The one trans woman in the study who reported a change in sexual orientation had arousal responses consistent with her pre-reassignment sexual orientation.

While undergoing hormone therapy, some trans men report experiencing increased sexual attraction to cisgender men.Vrangalova, Z. (2018, June 25). Research shows many trans folks' sexual attractions change after transition. Them. https://www.them.us/story/sexual-attraction-after-transition This change can be confusing for those who experience it because it is often not a change that they expect to happen.

However, gender transition does not always mean sexual orientation changes will happen. A 2021 study of 469 transgender women and 433 transgender men found that sexual orientation did not change over time or with hormonal transition.{{cite journal |last1 = Defreyne|first1 = J.|last2=Elaut|first2=E.|last3=Den Heijer|first3=M.|last4=Baudewijntje |first4=P.C.K.|last5=Fisher|first5=A.D.|last6=T'Sjoen|first6=G.|year = 2021|title = Sexual orientation in transgender individuals: Results from the longitudinal ENIGI study.| journal = International Journal of Impotence Research | volume = 33 | issue = 7 | pages = 694–702| doi = 10.1038/s41443-020-00402-7| pmid=33483604 | s2cid=231670933 }}

The DSM once had a diagnosis of "transvestic fetishism". Some therapists and activists sought to de-pathologize this category in future revisions.{{cite web|url=https://gidreform.wordpress.com/2010/10/16/ten-reasons-why-the-transvestic-fetishism-diagnosis-in-the-dsm-5-has-got-to-go/|title=Ten Reasons Why the Transvestic Disorder Diagnosis in the DSM-5 Has Got to Go|date=16 October 2010}} DSM 5, which was released in 2013, replaced the transvestic fetishism category with "transvestic disorder".{{cite web |url=http://www.dsm5.org/Documents/Paraphilic%2520Disorders%2520Fact%2520Sheet.pdf |title=Paraphilic Disorders |date=2013 |publisher=American Psychiatric Publishing |access-date=July 9, 2021 |archive-url=https://web.archive.org/web/20160724010712/https://www.dsm5.org/Documents/Paraphilic%20Disorders%20Fact%20Sheet.pdf |archive-date=July 24, 2016}}

Following the example of the Benjamin Scale, in 1979 Buhrich and McConaghy proposed three clinically discrete categories of fetishistic transvestism: "nuclear" transvestites who were satisfied with cross-dressing, "marginal" transvestites who also desired feminization by hormones or surgical intervention, and "fetishistic transsexuals", who had shown fetishistic arousal but who identified as transsexuals and sought sex reassignment surgery.

In many cultures, transgender people (especially trans women) are frequently involved in sex work such as transgender pornography. This is correlated with employment discrimination.{{cite journal |title=Transgender Women and the Sex Work Industry: Roots in Systemic, Institutional, and Interpersonal Discrimination |journal=Journal of Trauma & Dissociation |date=2013-09-24 |last1=Nadal |first1=Kevin |last2=Davidoff |first2=Kristin |last3=Fujii-Doe |first3=Whitney |volume=15 |issue=3 |pages=169–183 |doi=10.1080/15299732.2014.867572 |pmid=24313294 |s2cid=205869077 |url=https://www.tandfonline.com/doi/full/10.1080/15299732.2014.867572 |access-date=2021-06-07 |url-access=subscription }} In the 2011 National Trans Discrimination Survey, 11% of respondents reported having done sex work for income, compared to 1% of cisgender women in the US.{{cite web|url=http://transequality.org/PDFs/NTDS_Report.pdf|title=National Transgender Discrimination Survey: Full Report|date=2015-01-21|access-date=2013-04-28|archive-date=2011-08-03|archive-url=https://web.archive.org/web/20110803195534/http://www.transequality.org/PDFs/NTDS_Report.pdf|url-status=dead}} According to the same survey, 13% of transgender Americans are unemployed, almost double the national average.{{cite web|url=http://transequality.org/Resources/Trans_Discrim_Survey.pdf |archive-url=https://web.archive.org/web/20110728123651/http://transequality.org/Resources/Trans_Discrim_Survey.pdf |archive-date=2011-07-28 |title=National Transgender Discrimination Survey}} 26% had lost their jobs due to their gender identity/expression. Transgender sex workers have high rates of HIV. In a review of studies on HIV prevalence in trans women working in the sex industry, over 27% were HIV positive. However, the review found that trans women engaged in sex work were not more likely than trans women not engaged in sex work to be HIV positive.{{cite journal|title=Sex Work and HIV Status Among Transgender Women: Systematic Review and Meta-Analysis|journal=Journal of Acquired Immune Deficiency Syndromes|volume=48|issue=1|pages=97–103|doi=10.1097/QAI.0b013e31816e3971|pmid=18344875|year=2008|last1=Operario|first1=Don|last2=Soma|first2=Toho|last3=Underhill|first3=Kristen|s2cid=20298656}}

Studies have found that in the United States HIV is especially prevalent amongst transgender sex workers of color, particularly black trans women, a problem that has been identified by academics{{cite journal|title=HIV Prevalence, Risk Behaviors, Health Care Use, and Mental Health Status of Transgender Persons: Implications for Public Health Intervention|year=2001| pmc=1446468|pmid=11392934|volume=91|issue=6|journal=Am J Public Health|pages=915–21|doi=10.2105/ajph.91.6.915|last1=Clements-Nolle|first1=K|last2=Marx|first2=R|last3=Guzman|first3=R|last4=Katz|first4=M}} and members of the transgender community.

The subject of transgender sex workers has attracted attention in the media. Paris Lees, a British trans woman and journalist, wrote an article in June 2012 for the Independent defending criticism of Ria, star of Channel 4 documentary Ria: Teen Transsexual, who was seventeen at the time and depicted as working as a prostitute at a massage parlor, saying that the choice to engage in sex work is a matter of bodily autonomy and pointing out reasons that young trans women often turn to sex work such as low self-esteem and severe employment discrimination.{{cite web|last=Lees|first=Paris|url=http://blogs.independent.co.uk/2012/06/18/bodily-autonomy-confessions-of-a-transsexual-sex-worker/|work=The Independent|title=Paris Lees: Bodily autonomy- confessions of a transsexual sex worker|archive-url=https://web.archive.org/web/20130312084857/http://blogs.independent.co.uk/2012/06/18/bodily-autonomy-confessions-of-a-transsexual-sex-worker/|archive-date=2013-03-12}}

A review by GLAAD of its archives of transgender-inclusive television episodes from 2002 to 2012 found that 20% of transgender characters were depicted as sex workers.{{cite web|last=Kane|first=Matt|title=GLAAD EXAMINES TEN YEARS OF TRANSGENDER IMAGES ON TELEVISION; MORE THAN HALF WERE NEGATIVE OR DEFAMATORY|url=http://www.glaad.org/blog/glaad-examines-ten-years-transgender-images-television-more-half-were-negative-or-defamatory|date=2012-11-19|access-date=2013-05-08|archive-date=2020-12-05|archive-url=https://web.archive.org/web/20201205032823/https://www.glaad.org/blog/glaad-examines-ten-years-transgender-images-television-more-half-were-negative-or-defamatory|url-status=dead}} A 2020 Netflix documentary, Disclosure, explores this in more depth.{{Cite web|title=DISCLOSURE {{!}} Netflix Original Documentary {{!}} June 19 Release|url=http://www.disclosurethemovie.com/|access-date=2021-02-03|website=DISCLOSURE: Documentary by Sam Feder and Amy Scholder|language=en-US}}

Historically, transgender people were unable to access gender affirming care unless they would be considered heterosexual post surgery.{{Cite book|last=Haefele-Thomas, Ardel|title=Introduction to transgender studies|others=Combs, Thatcher,, Rains, Cameron,, Stryker, Susan,, Clifford, Jo, 1950-|date=5 February 2019|isbn=978-1-939594-28-0|location=New York, NY, USA|pages=107–110|oclc=1048658263}}{{Cite book|last=Gill-Peterson, Julian|title=Histories of the transgender child|date=23 October 2018|isbn=978-1-4529-5815-6|location=Minneapolis|pages=80–90|oclc=1027732161}} For much of the early 1900s, transgender persons were conflated with being either an invert or homosexual; as such, non-heterosexual sexual orientation data for transgender people is limited.{{Cite book|last=Skidmore, Emily|title=True sex: the lives of trans men at the turn of the twentieth century|date=19 September 2017|isbn=978-1-4798-7063-9|location=New York|oclc=982435476}} In the 1980s, Lou Sullivan was instrumental in allowing non-heterosexual transgender people access to surgical care and hormones.

Sexologist Magnus Hirschfeld first suggested a distinction based on sexual orientation in 1923.{{cite journal | last1 = Hirschfeld | first1 = M | year = 1923 | title = Die intersexuelle Konstitution | journal = Jarhbuch für Sexuelle Zwischenstufen | volume = 1923 | pages = 3–27 }} A number of two-type taxonomies based on sexuality have subsequently been proposed by clinicians, though some clinicians believe that other factors are more clinically useful categories, or that two types are insufficient.Doctor RF, Fleming JS (2001). Measures of Transgender Behavior. Archives of Sexual Behavior Volume 30, Number 3 / June, 2001 Some researchers have distinguished trans men attracted to women and trans men attracted to men.Rachlin, Katherine (1999) Factors Which Influence Individual's Decisions When Considering Female-To-Male Genital Reconstructive Surgery. IJT 3,3, {{cite web|url=http://www.symposion.com/ijt/ijt990302.htm |title=IJ TRANSGENDER - Factors Which Influence Individual's Decisions when Considering Female-To-Male Genital Reconstructive Surgery |access-date=2009-05-01 |archive-url=https://web.archive.org/web/20090318015035/http://www.symposion.com/ijt/ijt990302.htm |archive-date=2009-03-18 }}Deana F. Morrow, Lori Messinger (2006). Sexual Orientation and Gender Expression in Social Work Practice, p. 265. Columbia University Press, {{ISBN|978-0-231-12728-8}}

The Benjamin Scale proposed by endocrinologist Harry Benjamin in 1966 used sexual orientation as one of several factors to distinguish between "transvestites", "non-surgical" transsexuals, and "true transsexuals".Benjamin (1966). " [http://www.symposion.com/ijt/benjamin/chap_02.htm Benjamin Scale] {{webarchive|url=https://web.archive.org/web/20080913065950/http://www.symposion.com/ijt/benjamin/chap_02.htm |date=2008-09-13 }}

In 1974, Person and Ovesey proposed dividing transsexual women into "primary" and "secondary" transsexuals. They defined "primary transsexuals" as asexual persons with little or no interest in partnered sexual activity and with no history of sexual arousal to cross-dressing or "cross-gender fantasy". They defined both homosexual and "transvestic" trans people to be "secondary transsexuals".

Dr Norman Fisk noted those entering his clinic seeking reassignment surgery comprised a larger group than fit into the classical transsexual diagnosis. The article notes that effeminate gay men and heterosexual fetishistic transvestites desire surgery and could be considered good candidates for it.{{Cite journal|title = Editorial: Gender dysphoria syndrome--the conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen|journal = Western Journal of Medicine|date = 1974-05-01|issn = 0093-0415|pmc = 1130142|pmid = 4839483|pages = 386–391|volume = 120|issue = 5|first = N M|last = Fisk}}

In the DSM-II, released in 1968, "transsexualism" was within the "paraphilias" category, and no other information was provided.{{Cite book|title=DSM II|publisher=American Psychological Association|year=1968|location=Washington, D.C.|page=44}}

In the DSM-III-R, released in 1987, the category of "gender identity disorder" was created, and "transsexualism" was divided into "asexual", "homosexual", "heterosexual" and "unspecified" sub-types.{{Cite book|title=Diagnostic and statistical manual of mental disorders: DSM-III-R.|others=American Psychiatric Association., American Psychiatric Association. Work Group to Revise DSM-III.|year=1987|isbn=0-89042-018-1|edition=3rd edition, revised|location=Washington, DC|pages=71–78|oclc=16395933}}

In the DSM-IV-TR, released in 2000, "transsexualism" was renamed "gender identity disorder". Attraction specifications were to male, female, both, or neither, with specific variations dependent on birth sex.{{Cite book|title=Diagnostic and statistical manual of mental disorders: DSM-IV-TR.|date=2000|publisher=American Psychiatric Association|others=American Psychiatric Association., American Psychiatric Association. Task Force on DSM-IV.|isbn=0-89042-024-6|edition=4th ed., text revision|location=Washington, DC|pages=576–582|oclc=43483668}}

In the DSM-V, released in 2013 and currently used in the United States and Canada, "gender identity disorder" is now "gender dysphoria", and attraction specifications are either gynephillic or androphillic.{{Cite book|title=Diagnostic and statistical manual of mental disorders: DSM-5.|date=2013|publisher=American Psychiatric Association|others=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=978-0-89042-554-1|edition=5th|location=Arlington, VA|pages=452–459|oclc=830807378}}

{{Portal|Human sexuality}}

• Attraction to transgender people
• Lou Sullivan
• Queer heterosexuality
• Tri-Ess

{{reflist|refs=

American Psychological Association (APA)(2000) [http://www.mhsanctuary.com/gender/dsm.htm Gender Identity Disorder in DSM IV TR.]

Buhrish N, McConaghy N (1979). Three clinically discrete categories of fetishistic transvestism..Archives of Sexual Behavior Volume 8, Number 2 / March, 1979.

{{cite journal | last1 = Person | first1 = E | last2 = Ovesey | first2 = L | year = 1974 | title = The transsexual syndrome in males. I. Primary transsexualism | journal = American Journal of Psychotherapy | volume = 28 | issue = 1| pages = 4–20 | pmid = 4812111 | doi = 10.1176/appi.psychotherapy.1974.28.1.4 }}

{{cite journal | last1 = Person | first1 = E | last2 = Ovesey | first2 = L | s2cid = 5866529 | year = 1974b | title = The transsexual syndrome in males. II. Secondary transsexualism | journal = American Journal of Psychotherapy | volume = 28 | issue = 2| pages = 174–193 | pmid = 4829699 | doi = 10.1176/appi.psychotherapy.1974.28.2.174 }}

}}

{{Reflist}}

{{Transgender topics}}

{{LGBTQ|history=yes|culture=yes|rights=yes}}

{{DEFAULTSORT:Transgender sexuality}}

Category:Human sexuality